TF Situation and Control- Fiji. Mike Kama MOH Fiji

Transcription

1 TF Situation and Control- Fiji Mike Kama MOH Fiji

2 Profile Geographic Location 1 of 22 Small PIC- has 300 islands, 100 inhabited

3 Profile- Socio-Demographic Population (2007): Ethnicity: 57% Ethnic Fijians, 37% Fijians of Indian descent, Fijians of other descent 39% of pop is <20y.o Rural: Urban pop- 49%: 51% Of rural pop, 20% are in remote areas; of urban pop, 20% are in squatter settlements GDP per capita- $4 700 HDI (2008)- 86/169

4 Profile- Health 3 tiered health system Growth rate 0.7% Life expectancy (2005) at birth 68yrs IMR /1000 live births Intestinal infection- 3 rd major cause of morbidity, 8 th major COD

5 Typhoid Situation TF an intestinal infectious disease that imposes significant PH burden to Fiji population data: 1,847 cases and 6 deaths Spread to several new localities annually; either simultaneous or consecutive occurrences Outbreaks occur during warm dry season; natural disasters increase outbreak risk Frequency of dengue and lepto occurrences adds to difficulty in TF clinical diagnosis and early response

6 From a presentation by Drs Jacob Kool & David Whippy, WHO-WPRO, 2011

7 From presentation by Corinne Thompson and Dr Prem Singh, 2012

8 From presentation by Corinne Thompson and Dr Prem Singh, 2012

9 From presentation by Corinne Thompson and Dr Prem Singh, 2012

10 National TF Control Chronology 2005: major TF outbreak spurred TF control approach 2008: increase outbreaks; CD integrated response outbreak investigation and responses formulated 2009: a second major outbreak with 300+ confirmed cases in localized population prompted revision of prevailing integrated CD control guidelines and formulation of TF control guideline Vaccination of at-risk communities 2011 formation of focused National Taskforce for Control of Outbreak Prone Diseases- major activity control waves of TF outbreaks Assessment of vaccine effectiveness with community administration

11 Challenges Identified with TF Control Activities TF Outbreaks continued to spread to previously TF free localities No revision/assessment of prevailing integrated CD control guidelines and protocols to match international benchmark Incomplete knowledge of TF epidemiology/transmission dynamics human, behavioral, microbiological and environmental risk factors- no stance on vaccination use Vague knowledge of capacities needed for control program PH Law, Policy, Planning, Research- lack TF focus

12 Formulation of TF Control National Action Plan (NAP) MOH Fiji decision to formulate NAP in collaboration with International panel of TF experts and AusAID- 3 days meeting 2012 Expert recommendations formatted into 3 yrs TF national action plan Thematic areas of plan- Clinical and PH research to establish baseline information on TF risk(s); Environmental (WASH concept), Vaccination (community or school based), Behavioral, Clinical, Microbiological, M&E components

13 Update of Action Plan Plan regarded as sufficiently radical to subsequently generate innovative, effective and sustainable TF control and prevention strategies Baseline research is underway- see poster presentation by Principal investigator Conall Watson Other NAP strategies stagnant due to unavailability of funding NAP implementation anticipated to cost USD

14 Summary Points Fiji rapidly urbanizing country Infrastructure in remote communities and squatter settlements challenged TF predominant amongst ethnic Fijians, yrs age group, consistent spread to new localities annually TF NAP has radical strategies needed to bring about effective and lasting TF control and prevention functions Support needed to progress NAP implementation

15 Acknowledgements MOH/NTCOPD WHOSP/WPRO FHSSP/ AusAID Prof Kim Mulholland and team in Vietnam, Oxford and Melbourne Uni Members of the TF International Expert Panel Fiji Meeting/ CaT FNU CMNHS